What are hemorrhoids?
Hemorrhoids are enlarged, bulging blood vessels in and about the anus and lower rectum. There are two types of haemorrhoids
External (outside) hemorrhoids develop near the anus and are covered by very sensitive skin.
Internal (inside) hemorrhoids develop within the anus beneath the lining.
Internal hemorrhoids are classified by their degree of prolapse, which helps determine management:
Grade One: No prolapse
Grade Two: Prolapse that goes back in on its own
Grade Three: Prolapse that must be pushed back in by the patient
Grade Four: Prolapse that cannot be pushed back in by the patient (often very painful)
What causes hemorrhoids?
The upright posture of humans alone forces a great deal of pressure on the rectal veins, which sometimes causes them to bulge. Other contributing factors include:
- Aging
- Chronic constipation or diarrhoea
- Overeating,
- Heavy lifting
- Acid/alkaline imbalance
- Fatigue liver
- vitamin B-6 deficiency
- Pregnancy
- Heredity
- Straining during bowel movements
- Faulty bowel function due to overuse of laxatives or enemas
- Spending long periods of time (e.g., reading) on the toilet
- Sitting or standing in one position for long periods of time and lack of exercise can contribute to the development of hemorrhoid.
What are the symptoms?
If you notice any of the following, you could have hemorrhoids:
- Bleeding during bowel movements
- Protrusion during bowel movements
- Itching in the anal area
- Pain
- Sensitive lump(s)
How are hemorrhoids treated?
- Mild symptoms can be relieved frequently by increasing the amount of fibre (e.g., fruits, vegetables, breads and cereals) and fluids in the diet.
- Eliminating excessive straining reduces the pressure on haemorrhoids and helps prevent them from protruding.
- A sitz bath – sitting in plain warm water for about 10 minutes – can also provide some relief .
Treatment of 1 st and 2 nd grade Haemorrhoids
Ligation
The rubber band ligation over the internal haemorrhoids through gun is called ligation used in Gd 1 and Gd2 haemorrhoids
Bipolar Coagulation
Bipolar electrotherapy is applied for a directed coagulation effect of the mucous membrane near the haemorrhoid.
Hemorrhoidolysis
Therapeutic galvanic waves applied directly to the hemorrhoid, produces a chemical reaction that shrinks and dissolves hemorrhoidal tissue.
Infrared Photocoagulation
Infrared coagulation (IRC) is another office-base procedure, for Grades 1 and 2 and occasional Grade 3 internal hemorrhoids,
Sclerotherapy
It involves the injection of chemical irritants into the hemorrhoids, resulting in scarring and shrinkage by reducing the blood vessels present in the hemorrhoidal tissues.
Hemorrhoid stapling
this is a technique that uses a special device to internally staple and excise internal hemorrhoidal tissue.
Super Freezing
A cryogenic device uses liquid nitrogen to super freeze the hemorrhoid. This causes the affected tissue to slough off, so that new healthy tissue can grow in its place. This technique is most effective when it is used on external hemorrhoids.
Haemorrhoidal artery ligation
Haemorrhoidal artery ligation, is an operation to reduce the flow of blood to the haemorrhoids. It is usually carried out under general anaesthetic and uses a small ultrasound device called a Doppler probe. Ultrasound uses high-frequency sound waves to create an image of part of the inside of the body.
A review of a number of different studies looked at the results of haemorrhoidal artery ligation a year or more after the procedure. It found that about 1 in 10 people experienced:
- Bleeding
- Pain when passing stools
- A prolapsed haemorrhoid (where the haemorrhoid hangs out of the anus)
Surgical Treatment
Haemorrhoidectomy
Surgery to remove the haemorrhoids – is the most complete method for removal of internal and external haemorrhoids
Laser Surgery for Haemorrhoids
The unwanted haemorrhoid is vaporized or excised
The result is less discomfort, less medication, and faster healing. A hospital stay is generally not required. The laser is inherently therapeutic, sealing off nerves and tiny blood vessels with an invisible light. By sealing superficial nerve endings patients have a minimum of postoperative discomfort. With the closing of tiny blood vessels, your proctologist is able to operate in a controlled and bloodless environment.
Procedures can often be completed more quickly and with less difficulty for both patient and physician.
Atomizing Haemorrhoids
A new technique to remove hemorrhoids is called atomizing. The Atomizer™ is a medical device that was developed with a wave of the Atomizer Wand, the hemorrhoids are simply excised or vaporized one or more cell layers at a time.
The results of atomizing hemorrhoids are similar to that of lasering hemorrhoids, except that there is less bleeding using the Atomizer, and the Atomizer cost less. In both procedures, it is noted that there is less discomfort, less medication, less constipation, less urinary retention, and a hospital stay is generally not required. Complications using the Atomizer are rare, and excellent results are typical
Stapled Hemorrhoidopexy (PPH Procedure)
Also known as Procedure for Prolapsed Haemorrhoids (PPH), Stapled Haemorrhoidectomy, and Circumferential Mucosectomy.
PPH is a technique developed in the early 90’s that reduces the prolapse of haemorrhoidal tissue by excising a band of the prolapsed anal mucosa membrane with the use of a circular stapling device. In PPH, the prolapsed tissue is pulled into a device that allows the excess tissue to be removed while the remaining haemorrhoidal tissue is stapled. This restores the hemorrhoidal tissue back to its original anatomical position.
What are hemorrhoids?
Hemorrhoids are enlarged, bulging blood vessels in and about the anus and lower rectum. There are two types of haemorrhoids
External (outside) hemorrhoids develop near the anus and are covered by very sensitive skin.
Internal (inside) hemorrhoids develop within the anus beneath the lining.
Internal hemorrhoids are classified by their degree of prolapse, which helps determine management:
Grade One: No prolapse
Grade Two: Prolapse that goes back in on its own
Grade Three: Prolapse that must be pushed back in by the patient
Grade Four: Prolapse that cannot be pushed back in by the patient (often very painful)
What causes hemorrhoids?
The upright posture of humans alone forces a great deal of pressure on the rectal veins, which sometimes causes them to bulge. Other contributing factors include:
- Aging
- Chronic constipation or diarrhoea
- Overeating,
- Heavy lifting
- Acid/alkaline imbalance
- Fatigue liver
- vitamin B-6 deficiency
- Pregnancy
- Heredity
- Straining during bowel movements
- Faulty bowel function due to overuse of laxatives or enemas
- Spending long periods of time (e.g., reading) on the toilet
- Sitting or standing in one position for long periods of time and lack of exercise can contribute to the development of hemorrhoid.
What are the symptoms?
If you notice any of the following, you could have hemorrhoids:
- Bleeding during bowel movements
- Protrusion during bowel movements
- Itching in the anal area
- Pain
- Sensitive lump(s)
How are hemorrhoids treated?
- Mild symptoms can be relieved frequently by increasing the amount of fibre (e.g., fruits, vegetables, breads and cereals) and fluids in the diet.
- Eliminating excessive straining reduces the pressure on haemorrhoids and helps prevent them from protruding.
- A sitz bath – sitting in plain warm water for about 10 minutes – can also provide some relief .
Treatment of 1 st and 2 nd grade Haemorrhoids
Ligation
The rubber band ligation over the internal haemorrhoids through gun is called ligation used in Gd 1 and Gd2 haemorrhoids
Bipolar Coagulation
Bipolar electrotherapy is applied for a directed coagulation effect of the mucous membrane near the haemorrhoid.
Hemorrhoidolysis
Therapeutic galvanic waves applied directly to the hemorrhoid, produces a chemical reaction that shrinks and dissolves hemorrhoidal tissue.
Infrared Photocoagulation
Infrared coagulation (IRC) is another office-base procedure, for Grades 1 and 2 and occasional Grade 3 internal hemorrhoids,
Sclerotherapy
It involves the injection of chemical irritants into the hemorrhoids, resulting in scarring and shrinkage by reducing the blood vessels present in the hemorrhoidal tissues.
Hemorrhoid stapling
this is a technique that uses a special device to internally staple and excise internal hemorrhoidal tissue.
Super Freezing
A cryogenic device uses liquid nitrogen to super freeze the hemorrhoid. This causes the affected tissue to slough off, so that new healthy tissue can grow in its place. This technique is most effective when it is used on external hemorrhoids.
Haemorrhoidal artery ligation
Haemorrhoidal artery ligation, is an operation to reduce the flow of blood to the haemorrhoids. It is usually carried out under general anaesthetic and uses a small ultrasound device called a Doppler probe. Ultrasound uses high-frequency sound waves to create an image of part of the inside of the body.
A review of a number of different studies looked at the results of haemorrhoidal artery ligation a year or more after the procedure. It found that about 1 in 10 people experienced:
- Bleeding
- Pain when passing stools
- A prolapsed haemorrhoid (where the haemorrhoid hangs out of the anus)
Surgical Treatment
Haemorrhoidectomy
Surgery to remove the haemorrhoids – is the most complete method for removal of internal and external haemorrhoids
Laser Surgery for Haemorrhoids
The unwanted haemorrhoid is vaporized or excised
The result is less discomfort, less medication, and faster healing. A hospital stay is generally not required. The laser is inherently therapeutic, sealing off nerves and tiny blood vessels with an invisible light. By sealing superficial nerve endings patients have a minimum of postoperative discomfort. With the closing of tiny blood vessels, your proctologist is able to operate in a controlled and bloodless environment.
Procedures can often be completed more quickly and with less difficulty for both patient and physician.
Atomizing Haemorrhoids
A new technique to remove hemorrhoids is called atomizing. The Atomizer™ is a medical device that was developed with a wave of the Atomizer Wand, the hemorrhoids are simply excised or vaporized one or more cell layers at a time.
The results of atomizing hemorrhoids are similar to that of lasering hemorrhoids, except that there is less bleeding using the Atomizer, and the Atomizer cost less. In both procedures, it is noted that there is less discomfort, less medication, less constipation, less urinary retention, and a hospital stay is generally not required. Complications using the Atomizer are rare, and excellent results are typical
Stapled Hemorrhoidopexy (PPH Procedure)
Also known as Procedure for Prolapsed Haemorrhoids (PPH), Stapled Haemorrhoidectomy, and Circumferential Mucosectomy.
PPH is a technique developed in the early 90’s that reduces the prolapse of haemorrhoidal tissue by excising a band of the prolapsed anal mucosa membrane with the use of a circular stapling device. In PPH, the prolapsed tissue is pulled into a device that allows the excess tissue to be removed while the remaining haemorrhoidal tissue is stapled. This restores the hemorrhoidal tissue back to its original anatomical position.
What are the Risks of PPH?
- If too much muscle tissue is drawn into the device, it can result in damage to the rectal wall.
- The internal muscles of the sphincter may stretch, resulting in short-term or long-term dysfunction.
- As with other surgical treatments for haemorrhoids, cases of pelvic sepsis have been reported following stapled haemorrhoidectomy.
- PPH may be unsuccessful in patients with large confluent haemorrhoids.
- Persistent pain and fecal urgency after stapled haemorrhoidectomy, although rare, has been reported.
- Stapling of hemorrhoids is associated with a higher risk of recurrence and prolapse than conventional hemorrhoid removal surgery; according to a Canadian study of 537 participants.
The Harmonic Scaplel
The Harmonic Scaplel uses ultrasonic technology, the unique energy form that allows both cutting and coagulation of hemorrhoidal tissue at the precise point of application, resulting in minimal lateral thermal tissue damage. Because the Harmonic Scaplel uses ultrasound, there is less smoke than is generated by both lasers and electrosurgical instruments. The Harmonic Scaplel cuts and coagulates by using lower temperatures than those used by electrosurgery or lasers.
The protein coagulum caused by the application of the Harmonic Scaplel is superior at sealing off large bleeding vessels during surgery. It has been my experience that this method is useful on large hemorrhoids that may bleed during surgery, thus minimizing blood loss and reducing the time needed for surgery.
Do hemorrhoids lead to cancer?
No. There is no relationship between hemorrhoids and cancer.
OFFICE TREATMENT OF EXTERNAL HEMORRHOIDS
External hemorrhoids, which are not thrombosed, are generally managed symptomatically, with dietary management and topical agents. Only occasionally are they removed surgically.
What are the Risks of PPH?
- If too much muscle tissue is drawn into the device, it can result in damage to the rectal wall.
- The internal muscles of the sphincter may stretch, resulting in short-term or long-term dysfunction.
- As with other surgical treatments for haemorrhoids, cases of pelvic sepsis have been reported following stapled haemorrhoidectomy.
- PPH may be unsuccessful in patients with large confluent haemorrhoids.
- Persistent pain and fecal urgency after stapled haemorrhoidectomy, although rare, has been reported.
- Stapling of hemorrhoids is associated with a higher risk of recurrence and prolapse than conventional hemorrhoid removal surgery; according to a Canadian study of 537 participants.
The Harmonic Scaplel
The Harmonic Scaplel uses ultrasonic technology, the unique energy form that allows both cutting and coagulation of hemorrhoidal tissue at the precise point of application, resulting in minimal lateral thermal tissue damage. Because the Harmonic Scaplel uses ultrasound, there is less smoke than is generated by both lasers and electrosurgical instruments. The Harmonic Scaplel cuts and coagulates by using lower temperatures than those used by electrosurgery or lasers.
The protein coagulum caused by the application of the Harmonic Scaplel is superior at sealing off large bleeding vessels during surgery. It has been my experience that this method is useful on large hemorrhoids that may bleed during surgery, thus minimizing blood loss and reducing the time needed for surgery.
Do hemorrhoids lead to cancer?
No. There is no relationship between hemorrhoids and cancer.
OFFICE TREATMENT OF EXTERNAL HEMORRHOIDS
External hemorrhoids, which are not thrombosed, are generally managed symptomatically, with dietary management and topical agents. Only occasionally are they removed surgically.
